Heartbeat perception in depression

Alterations in bodily awareness have been implicated in depression but there has been little detailed empirical characterisation of the degree and accuracy of body perception in the disorder. The present study examined the objective accuracy of heartbeat perception (using the Schandry mental tracking task) and the subjective degree of bodily focus (using the Bodily Consciousness Questionnaire; BCQ) in healthy control volunteers, a moderately depressed community sample, and a more severely depressed clinic sample (n=18 in each group). The community sample showed less accurate heartbeat perception than the control group as expected. Counter to prediction, however, the more severely depressed clinic sample performed better than the community depressed sample and equivalently to control volunteers on the Schandry task. There were no group differences on subjective bodily awareness. Implications for theories of depression are discussed.     

Cognitive-behaviour therapy for chronic fatigue syndrome: comparison of outcomes within and outside the confines of a randomised controlled trial

Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N=30) and patients who received CBT as part of everyday clinical practice (N=384). The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up. Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended.     

An analogue study of the effects of Psychological Debriefing on eyewitness memory

Sixty-one participants from the community participated in a randomised controlled trial of group debriefing to assess the effect of this intervention upon memory for a stressful event. Participants were randomly allocated to one of three groups: debriefing; debriefing with an experimenter confederate present (who supplied three pieces of misinformation to the group regarding the stressful event); and a no-treatment control. All groups were shown a very stressful video and were again reviewed after 1 month. Members of the debriefing group where a confederate provided misinformation were more likely to recall this misinformation as fact than members of the other two groups. The debriefing group was also more accurate in their recall of peripheral content than the confederate group. Across all groups, participants were found to be more accurate at central rather than peripheral recall yet more confident for incorrect memories of the video than correct memories.     

Attention attenuates metacontrast masking

The influence of attention on perceptual awareness was examined using metacontrast masking. Attention was manipulated with endogenous cues to assess the effects on the temporal and spatial parameters of target visibility. Experiment 1 examined the time course of effective masking when the target and mask set were presented at an attended vs. an unattended location. The valid allocation of attention decreased the magnitude of the masking effect (i.e. increased visibility) for approximately 80 ms. Furthermore, even with spatial displacements of the target and mask and center-to-center separations of 1.5 degrees or 2.7 degrees of visual angle (Experiment 2), target visibility was increased when attention was validly allocated. These results indicate that attention influences low-level visual processes to enhance visual awareness.     

Relational schemas and the developing self: perceptions of mother and of self as joint predictors of early adolescents' self-esteem

This 1-year longitudinal study examined early adolescents' (N=278, age 11-13 years) perceptions of their mother's behavior (affection, knowledge of child's activities, and psychological control) and of how they react to their mother (trust in mother, defiance, and debilitation) as predictors of self-esteem among peers. Perceived maternal affection predicted self-esteem for girls; perceived psychological control forecast lower self-esteem for boys. Perceptions of self as untrusting, defiant, or debilitated led to lower self-esteem. Furthermore, perceived maternal behavior interacted with perceived self-reactions to predict self-esteem: Perceived debilitation led to reduced self-esteem only under high perceived maternal psychological control; perceived defiance predicted lower self-esteem only under low perceived maternal knowledge. The prediction of self-esteem is clearly enhanced when perceived self-reactions are included along with perceived maternal behavior as predictors. Combinations of perceived maternal behavior and perceived self-reactions--relational schemas--warrant increased attention as possible influences on the developing self.     

Acute dissociation after 1 night of sleep loss

Recent research has shown that dissociative symptoms are related to self-reports of deviant sleep experiences. The present study is the 1st to explore whether sleep loss can fuel dissociative symptoms. Twenty-five healthy volunteers were deprived of sleep for 1 night. Sleepiness and dissociative symptoms were assessed every 6 hr. The authors measured both spontaneous dissociative symptoms and dissociative symptoms induced by dot-staring during sensory deprivation. Sleepiness as well as spontaneous and induced dissociative symptoms were stable throughout the day but increased during the night. These findings provide further evidence for a robust relationship between disruptions in sleep patterns and dissociative symptoms.     

The making of an analyst: from 'ideal' to 'good-enough'

This paper addresses the issue of variances in training modalities and how this is linked to one's personal experience of training and to one's analytic lineage. The author, who bases his reflections on discussions held during the yearly directors of training meeting of the North American Jungian Societies, suggests that, while each institute aims to provide an 'ideal' training programme for its candidates, the philosophy underlying how this ideal is defined depends, in large part, on the theoretical and philosophical orientation of the founding fathers and mothers. This results in a form of analytic lineage that necessarily impacts on the form and content of the 'ideal' programme. Shadow issues related to analytic lineage in the admissions procedures, case consultation, exam committees and review committees are presented. Motivation for why we choose to train and reflections on what makes an analyst 'Jungian' are explored.     

Evaluating the influence of postsession reinforcement on choice of reinforcers

Factors that influence reinforcer choice have been examined in a number of applied studies (e.g., Neef, Mace, Shea, & Shade, 1992; Shore, Iwata, DeLeon, Kahng, & Smith, 1997; Tustin, 1994). However, no applied studies have evaluated the effects of postsession reinforcement on choice between concurrently available reinforcers, even though basic findings indicate that this is an important factor to consider (Hursh, 1978; Zeiler, 1999). In this bridge investigation, we evaluated the influence of postsession reinforcement on choice of two food items when task responding was reinforced on progressive-ratio schedules. Participants were 3 children who had been diagnosed with developmental disabilities. Results indicated that response allocation shifted from one food item to the other food item under thinner schedules of reinforcement when no postsession reinforcement was provided. These findings suggest that the efficacy of instructional programs or treatments for problem behavior may be improved by restricting reinforcers outside treatment sessions.     

Medicare's search for effective obesity treatments: diets are not the answer

The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.     

Fear conditioning in posttraumatic stress disorder: evidence for delayed extinction of autonomic, experiential, and behavioural responses

Aversive conditioning has been proposed as an important factor involved in the etiology of posttraumatic stress disorder (PTSD). However, it is not yet fully understood exactly which learning mechanisms are characteristic for PTSD. PTSD patients (n=36), and healthy individuals with and without trauma exposure (TE group, n=21; nTE group, n=34), underwent a differential fear conditioning experiment consisting of habituation, acquisition, and extinction phases. An electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures as conditioned stimuli (CS+, paired; CS-, unpaired). Conditioned responses were quantified by skin conductance responses (SCRs), subjective ratings of CS valence and US-expectancy, and a behavioural test. In contrast to the nTE group, PTSD patients showed delayed extinction of SCRs to the CS+. Online ratings of valence and US-expectancy as well as the behavioural test confirmed this pattern. These findings point to a deficit in extinction learning and highlight the role of affective valence appraisals and cognitive biases in PTSD. In addition, there was some evidence that a subgroup of PTSD patients had difficulties in learning the CS-US contingency, thereby providing preliminary evidence of reduced discrimination learning.